Chained children in Pakistan: Not an uncommon treatment for addicts

Police rescued dozens of students at an Islamic seminary Monday in the Pakistani city of Karachi, saying that some of them were drug addicts kept in chains. While the case has gained global notoriety, this form of “rehabilitation” is not unheard of in the region.

The Associated Press reported that parents of some 60 youths paid the seminary to “treat their children through a regime of Islamic instruction and worship, or simply to take them off their hands.”

Chaining as a form of rehabilitation goes on in other religious institutions in the region, most notably Sufi shrines. I reported for the Monitor in 2009 on a shrine outside Jalalabad, Afghanistan, where families would leave relatives who were mentally ill or addicted to drugs.

A standard treatment at the shrine was to chain a patient for 40 days, either in a small cell or to a tree in the courtyard, and administer a strict diet of bread and black pepper:

"Mia Sahib, one of the shrine-keepers, explains that his patients are possessed by demons known as djinns. For some, he offers a taweez - a Koranic verse written on a slip of paper. Others require 40 days of confinement.

"A mental patient doesn't know himself," explains Mia Sahib. "In 40 days, he is going to know himself fast. He will know he has some djinn inside. Once he knows he has a djinn inside, he will clean himself. And once he cleans himself, he will know Allah."

Mia Sahib claimed to have some success with this method, but he admitted he could do little for patients addicted to opium. Yet, during my visit, he was still confining in chains a drug addict named Waseem from Pakistan. Waseem explained that a relative had tricked him into making the journey that resulted in his imprisonment.

Reports out of Karachi talk of grubby conditions in the basement of the seminary where the students were chained.

The men were not allowed to use the bathrooms at night either. “It’s embarrassing to tell but we were given a water bottle to pee in. If we urinated in bed, we were lashed,” said Babar, a teenager. 

I observed similar conditions at the shrine. Each of the patients lived alone in a tiny cell with no door. Each had only a couple feet at most of slack in the chain that linked his ankle to the nearby wall. Some would use uncollected trash in their sell to fling their own waste out the doorway.

Afghanistan has made some strides in modernizing its mental health system, including upgrades to psychiatric wards and the replacement of chains with medication. But mental health doctors still expressed frustration that people sometimes still preferred to send their relatives to shrines like the one outside Jalalabad.

The mental health community in Afghanistan is hoping education campaigns will eventually put the shrines out of work. Meanwhile, the Karachi case is focusing renewed attention on madrassah reform, with critics arguing the seminaries need more oversight to prevent cases of physical and sexual abuse. One of the most gripping pleas for reform came days before the Karachi raid, when a former madrassah student penned a first-person essay about the abuse he experienced.